scholarly journals Xanthogranuloma of nose in an adult: an uncommon presentation

Author(s):  
Seetu Palo ◽  
Ashwinkumar K. Barsagade ◽  
Neha Sikdar

<p class="abstract">Xanthogranuloma is a relatively rare histiocytic cutaneous disorder that typically affects the pediatric age group. Its occurrence in adulthood is still rarer with only a handful of cases on the record. The present case report describes a case of adult-onset xanthogranuloma in a 49 years old lady who presented to the otorhinolaryngology clinic with a 6 months history of a nodule on the left side of the columella. There was no history of associated pain or bleeding from the site. Local examination revealed a 0.6×0.6 cm, non-tender, soft-to-firm, pinkish dome-shaped lesion with rounded edges. No similar lesions were found elsewhere. Excisional biopsy of the lesion was performed and microscopy showed a dermal lesion comprising of sheets of histiocytes admixed with lymphoplasmacytic infiltrate, touton giant cells and few spindle cells. A diagnosis of xanthogranuloma was rendered. A number of lympho-histiocytic lesions comes in the differential diagnosis of xanthogranuloma and hence it is important to be aware of such unusual presentations in order to make correct histological diagnosis.</p>

2007 ◽  
Vol 15 (3) ◽  
pp. 169-172 ◽  
Author(s):  
Mark M Melendez ◽  
Xiaoti Xu ◽  
Steve A Mcclain ◽  
Su-I Daniel Huang

Atypical fibroxanthoma (AFX) is an uncommon neoplasm, identified as a spindle cell tumour that is generally found in elderly patients on sun-exposed areas. The majority of cases of AFX are benign, and metastasis is a rare phenomenon. The first case in the literature of AFX is described in a young woman with no previous risk factors who presented with a three-month history of an enlarging nodule of the left nasal alar. Excision showed the lesion to be composed of hyperchromatic, pleomorphic, vacuolated spindle cells and multinucleated giant cells. The tumour cells stained positive for macrophage-histiocyte antigen alpha1-antitrypsin, neurokinin-1, CD68 and alpha1-antichymotrypsin. The present case report highlights the importance of correct diagnosis for AFX with adequate excision and by considering the histopathology and immunohisto-chemistry of its clinical differential diagnosis.


2017 ◽  
Vol 9 (2) ◽  
pp. 53-56
Author(s):  
Farah Abdulla ◽  
Heather Peck ◽  
Ashley Feneran ◽  
Ashley Jenkins ◽  
Katherine Mullersman

Abstract Introduction. Lipidized dermatofibromas represent rare and often underrecognized variants of dermatofibromas. Histologically, dermatofibromas are composed of fibroblast-like spindle cells, foam cells, giant cells, siderophages, lymphocytes, capillaries, collagen fibers, and hyaline dermal collagen fibers. Lipidized dermatofibromas are characterized by numerous foam cells, Touton giant cells, and hyalinized wiry collagen in the stroma. Case report. We present a case of a 31-year-old woman with a history of hypothyroidism and alopecia areata, presenting with an enlarging 8 mm, firm erythematous nodule on her upper-mid back. Biopsy examination showed a cellular proliferation of spindle cells with peripheral collagen trapping and cholesterol clefts with associated foam cells and sclerosis, staining weakly positive for Factor XIIIa and negative for CD34. The diagnosis of a benign lipidized dermatofibroma was rendered. Conclusion. Lipidized dermatofibromas are rare histologic variants of dermatofibromas, biologically indolent, and should be distinguished from other cutaneous foamy histiocytic lesions, particularly xanthomas, which may alter patient management.


2019 ◽  
Vol 7 ◽  
pp. 2050313X1984735 ◽  
Author(s):  
Catherine F Roy ◽  
Simon F Roy ◽  
Feras M Ghazawi ◽  
Erica Patocskai ◽  
Annie Bélisle ◽  
...  

We present a case of a 64-year-old man who presented with a rapidly growing tumor in the left buttock and intergluteal cleft area, which was affected by hidradenitis suppurativa. The patient was on tumor necrosis factor-alpha inhibitors for hidradenitis suppurativa for 2 years prior to the development of the mass. Initial biopsy of the mass showed a well-differentiated squamous cell carcinoma with spindle cells and positive epithelial immunomarkers. Subsequent excisional biopsy of the tumor showed an infiltrating poorly differentiated squamous cell carcinoma composed of islands of atypical sarcomatoid spindle cells. Squamous cell carcinoma arising in hidradenitis suppurativa is a rare complication which may occur secondary to chronic inflammation and epidermal hyperproliferation in hidradenitis suppurativa–affected areas.


2013 ◽  
Vol 79 (11) ◽  
pp. 1140-1141 ◽  
Author(s):  
Ann A. Albert ◽  
Tracy L. Nolan ◽  
Bryan C. Weidner

Sigmoid volvulus, a condition generally seen in debilitated elderly patients, is extremely rare in the pediatric age group. Frequent predisposing conditions that accompany pediatric sigmoid volvulus include intestinal malrotation, omphalomesenteric abnormalities, Hirschsprung's disease, imperforate anus and chronic constipation. A 16-year-old previously healthy African American male presented with a 12 hour history of sudden onset abdominal pain and intractable vomiting. CTwas consistent with sigmoid volvulus. A contrast enema did not reduce the volvulus, but it was colonoscopically reduced. Patient condition initially improved after colonoscopy, but he again became distended with abdominal pain, so he was taken to the operating room. On exploratory laparotomy, a band was discovered where the mesenteries of the sigmoid and small bowel adhered and created a narrow fixation point around which the sigmoid twisted. A sigmoidectomy with primary anastomosis was performed. The diagnosis of sigmoid volvulus may be more difficult in children, with barium enema being the most consistently helpful. Seventy percent of cases do not involve an associated congenital problem, suggesting that some pediatric patients may have congenital redundancy of the sigmoid colon and elongation of its mesentery. The congenital band found in our patient was another potential anatomic factor that led to sigmoid volvulus. Pediatric surgeons, accustomed to unusual problems in children, may thus encounter a condition generally found in the debilitated elderly patient.


2021 ◽  
pp. 72-73
Author(s):  
Laxmi Rathore ◽  
P. K. Khatri ◽  
Saroj K. Meena ◽  
Archana Bora ◽  
Suneel Bhooshan

Acute Febrile Encephalopathy is a clinical term used to describe patients presenting with short febrile illnesses with altered mental states. Demographic distribution plays an essential role in the diagnosis of viral etiologies. One hundred ve suspected AFE cases were enrolled in the study. A detailed history by predesigned performa and laboratory investigations was obtained for data collection. Viral etiology was diagnosed in 32 (30.48%) cases. The male to female ratio was 1.39:1. Total 56.25% of positive cases were from the lower class, 28.13% from the middle class, and 15.63% from the upper class. 24 (75%) cases from rural, while only 8 (25%) of the urban population showed viral etiologies. In 19 (59.4%) cases were either history of incomplete vaccination or not vaccinated, 13 (40.6%) cases had a history of complete immunization among positive cases. The predominant clinical feature was fever (100%) followed by seizures 66(62.86%), vomiting 37(35.24%), headache 14(13.33%), paresis in 16(15.24%) and altered sensorium in 29(27.62%), respectively. To conclude, the etiologic panorama of AFE varies with several factors such as time and demographical location, age, and immunization status. There is an urgent need to conduct more studies to prole the viral etiologies according to their prevalence in geographical areas so the treatment can be tailored accordingly and prophylaxis treatment or immunization can be boosted in the population at risk of getting the disease.


2004 ◽  
Vol 128 (8) ◽  
pp. 918-921
Author(s):  
Michelle Reid-Nicholson ◽  
Muhammed Idrees ◽  
Giorgio Perino ◽  
Prodromos Hytiroglou

Abstract Sarcomatoid carcinoma of the small bowel is rare; to our knowledge, 19 cases have been reported to date in the English literature under several names. We report an additional case occurring in the jejunum of a 55-year-old man. The tumor was a polypoid 7.5-cm mass, which infiltrated the full thickness of the intestinal wall and the serosa of an adhesed loop of small bowel. On microscopic examination, the neoplasm was composed of sheets of spindle cells; focally, an anaplastic component was present, including tumor giant cells with bizarre nuclei. On immunohistochemical stains, tumor cells were positive for cytokeratin 7, cytokeratin AE1/AE3, vimentin, and focally, epithelial membrane antigen. No staining for cytokeratin 20 was found. Sarcomatoid carcinoma must be kept in mind in the differential diagnosis of malignant spindle cell tumors of the small bowel. As consensus regarding the terminology of these rare tumors is being reached, immunohistochemical stains are essential for accurate diagnosis.


2021 ◽  
Vol 14 (7) ◽  
pp. e243506
Author(s):  
Naim Izet Kajtazi ◽  
Shahpar Nahrir ◽  
Wafa Al Shakweer ◽  
Juman Al Ghamdi ◽  
Ali Al Fakeeh ◽  
...  

Frequently the cause of raised intracranial pressure remains unresolved and rarely is related to spinal tumours, moreover less to spinal medulloblastoma without primary brain focus. An 18-year-old woman had a 3-month history of headache and impaired vision. Neurological examination revealed bilateral sixth cranial nerve palsies with bilateral papilloedema of grade III. No focal brain or spine lesion was found on imaging. Consecutive lumbar punctures showed high opening pressure and subsequent increasing protein level. Meningeal biopsy was negative. At one point, she developed an increasing headache, vomiting and back pain. Spine MRI showed diffuse nodular leptomeningeal enhancement with the largest nodule at T6–T7. Malignant cells were detected in cerebrospinal fluid. She underwent laminectomy with excisional biopsy, and pathology showed medulloblastoma WHO grade IV. She was treated with chemotherapy and craniospinal irradiation and made a good recovery.


2006 ◽  
Vol 5 (1) ◽  
pp. 13-16
Author(s):  
Raj Kandasamy ◽  
◽  
Asha Srikanth ◽  
SM Rutter ◽  
CJ Butcher ◽  
...  

Psoas abscess is an uncommon presentation on the acute medical take. However recognition and appropriate treatment is essential. This review is designed to highlight the clinical features, microbiology, diagnostic tests and treatment for this condition. In order to illustrate some of the pitfalls and complexities in the management of psoas abscess we have included a case history of a patient who was recently treated in our department.


2018 ◽  
Vol 4 (1) ◽  
pp. 38-40
Author(s):  
Sundeep Chowdhry ◽  
Prashansa Jaiswal ◽  
Tapan Kumar Dhali ◽  
Akhilesh Shukla

A 3 year old girl presented with a two- day history of multiple fluid filled lesions on buttocks and back of left thigh. As informed by the child's mother, she had fever 4 days back and was irritable with pain and discomfort on back of the left thigh. The pain was episodic and radiated from buttocks to the leg. On examination, multiple fluid filled lesions of various sizes with surrounding erythema were present involving the S1, S2, S3 dermatomes extending from buttock to the sole sparing few areas in between the vesicles. On further examination of whole body, there were multiple discrete fluid filled lesions on erythematous base ranging from 0.1 to 0.3 mm diameter in size on chest, abdomen and back. Multinucleated giant cells with acantholytic cells were found in Tzank smears. Diagnosis of concurrent varicella with herpes zoster was made.Journal of Universal College of Medical Sciences (2016) Vol.04 No.01 Issue 13, Page: 38-40


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